Management Through Risk Factor Modification

Abstract

The prevalence of obesity has reached epidemic proportions in recent years. Therapeutic lifestyle change is widely accepted as the best first step for managing cardiometabolic risk factors. Patients, however, find it difficult to adhere to these recommendations, and many ultimately require pharmacotherapy to achieve treatment goals for blood pressure, glucose, and lipids. Although there are many safe and effective agents for managing these 3 cardiometabolic risk factors, pharmacologic options for weight loss are limited. Researchers have shown that dietary counseling helps some patients achieve weight loss, but these improvements diminish over time. The combination of diet with exercise results in greater initial weight loss than diet alone, but this loss is only partially sustained after 1 year. The American College of Sports Medicine/American Heart Association recently published updated recommendations for physical activity for healthy adults that reiterate the value of relatively moderate exercise: as little as 30 minutes a day, 5 days a week, can yield substantial health benefits. Unfortunately, most individuals find it just as difficult to adhere to an exercise regimen over the long term as they do to maintain a weight-loss diet. Only 11% to 19% of patients with diabetes who begin an exercise regimen will continue to exercise for an entire year.